Continuous Positive Airway Pressure-Mandibular Advancement Device Combination Therapy for Moderate-to-Severe Obstructive Sleep Apnea: A Preliminary Study

Thyagaseely Sheela Premaraj, Jacob Stadiem, Shyamaly Arya Premaraj, Charles R. Davies, Matthew Dennis, John J. Harrington

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: The purpose of this pilot study was to determine whether compliance to auto-adjusting positive airway pressure (APAP) improves with the addition of a mandibular advancement device (MAD). Secondary outcome measures included were APAP pressure, subjective daytime sleepiness, apnea-hypopnea index (AHI), and mask leaks. Setting and Sample Population: Participants included were diagnosed with moderate-to-severe obstructive sleep apnea (OSA) and became noncompliant to prescribed APAP. Thirteen participants with a mean age of 61.6 years were recruited for this study. Materials and Methods: All participants were given a MAD to use with their APAP. Parameters measured included APAP pressure, AHI, mask leak reported via ResMed AirViewTM software, and self-reported daytime sleepiness (Epworth Sleepiness Scale [ESS]). A paired two-sample for mean t -test was performed to determine significance. Results: The mean difference of pre- and postintervention APAP compliance was 23.1%, which was statistically significant (p = 0.015). The mean APAP air pressures were unchanged. The difference between pre- and postintervention mean ESS scores was 1.4 and was statistically significant (p = 0.027). The mean difference between pre- and postintervention AHI values and mask leak showed no significant difference. Conclusion: This study showed that combination of APAP-MAD therapy, for patients with moderate-to-severe OSA who were noncompliant to APAP use, significantly increased compliance with APAP therapy, and significantly decreased the daytime sleepiness of participants.

Original languageEnglish (US)
JournalEuropean Journal of Dentistry
DOIs
StateAccepted/In press - 2021

Keywords

  • auto-adjusting positive airway pressure
  • Epworth Sleepiness Scale scores
  • mandibular advancement device
  • obstructive sleep apnea

ASJC Scopus subject areas

  • Dentistry(all)

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